Silver-coated tibial plateau leveling osteotomy implants do not improve surgical site infection rates over noncoated implants in a randomized trial in 73 canines

Abstract

Abstract OBJECTIVE To evaluate the incidence of surgical site infections (SSIs) in dogs undergoing a tibial plateau leveling osteotomy (TPLO) with silver-coated (SC) and noncoated (NC) TPLO plates. ANIMALS 65 dogs (73 surgical procedures). METHODS Client-owned dogs undergoing a TPLO procedure between November 2021 and May 2023 were prospectively enrolled. Dogs were randomly assigned either an SC or NC TPLO plate at the time of surgery. Follow-up was performed at 2 weeks and 8 weeks postoperatively by in-person examination, client questionnaire, or telephone interview. Dogs were followed up 100 days postoperatively for any incisional or implant complications. RESULTS Among 73 stifles that underwent a TPLO, the overall SSI rate was 8.2% (6/73), with an infection rate of 14.3% (5/35) in the NC group and 2.6% (1/38) in the SC group; this difference was not significant (P = .17). Five of these infections were superficial, and only 1 deep SSI was recorded within the 100-day study period (NC group). CLINICAL RELEVANCE Although no significant difference was noted between the SC and NC groups, likely due to a small sample size and overall low infection rate, there was a trend showing a higher infection rate in the NC group. No conclusions can be drawn on the impact of silver coating on deep or organ/space incisional infections due to the low incidence reported in this study (n = 1). Further investigation of SC TPLO implants in a larger and more long-term clinical study is warranted.